Billing code 69222: Mastoid cleaningMedicare rate & RVUs in Guam
Reports complicated debridement of a mastoidectomy cavity, such as an established mastoid bowl requiring more involved removal of accumulated debris.
Medicare pays $236.10 for 69222 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 69222 covers
An otolaryngologist typically performs this service to clear accumulated material from a mastoidectomy cavity, often called a mastoid bowl, during an office visit. The work may involve removing keratin, crusting, or other debris from the surgically altered cavity. This is distinct from clearing wax or a foreign body from the external ear canal. The code is for complicated cavity debridement; a routine or simple cleaning belongs to the related lower-level service.
Select the code based on the documented complexity of the cavity debridement, not solely on the fact that the patient previously had mastoid surgery. Record the cavity findings, material removed, and work performed to support the service level. It has a 10-day global period, so related postoperative visits during that period are included. When performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. For bilateral work, modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
69222 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $236.10 | $132.81 |
How the 69222 rate is calculated
Each of 69222’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 69222
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.41Practice expense 4.87Malpractice 0.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69222
69222 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69222
Mastoid cleaning
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69222
Mastoid cleaning
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69222 without 50 · national office
$216.77
Mastoid cleaning
69222-50 · Bilateral: 150%
$325.16
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
69222 compared with similar codes
Compare codes
69222 vs 69220 vs 69200 vs 69205 vs 69210: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69220Mastoid cleaning
- This is the simple mastoidectomy-cavity debridement code. Choose 69222 when the documented cavity cleaning is complicated.
- 69200Ear canal removal
- This code concerns removal of a foreign body from the external auditory canal without general anesthesia, not debridement of a mastoidectomy cavity.
- 69205Ear foreign body removal
- This code concerns external auditory canal foreign-body removal with general anesthesia; it does not describe mastoid cavity cleaning.
- 69210Impacted ear wax removal
- This code is for impacted cerumen removal from the external auditory canal by instrumentation, rather than debridement of a mastoidectomy cavity.
69222 billing questions
How do I choose between 69222 and 69220?
Use 69222 for complicated mastoidectomy-cavity debridement and 69220 for simple debridement. Document the cavity findings and work that support the selected level.
Is cleaning wax from the ear canal reported with 69222?
No. 69222 concerns a mastoidectomy cavity; cerumen removal from the external auditory canal is a different service and may be coded with 69209 or 69210, depending on the method.
Does 69222 have a postoperative global period?
Yes. It has a 10-day global period, which includes related postoperative visits during those 10 days.
How is bilateral mastoid cavity debridement reported?
For bilateral work, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be paid for this service?
Assistant-at-surgery payment is statutorily restricted. Co-surgeon and team-surgery payment are not permitted.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the other procedures are subject to the standard multiple-procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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